@layout("/common/_container.html"){
<div class="ibox float-e-margins">
    <div class="ibox-content">
        <div class="ibox float-e-margins">
            <div class="ibox-title">
                <h5>打印</h5>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-6" style="text-align: right">
                <img src="${ctxPath}/static/img/bg.png" style="width: 80px;height: 80px">
            </div>
            <div class="col-sm-6">
                <div class="row">
                    <h5>福州鑫合顺物流货物自提清单1</h5>
                </div>
                <div class="row">
                    地址：福建省福州市仓山区望峰路11号2号仓库门
                </div>
                <div class="row">
                    电话：0591-83302989
                </div>
            </div>
        </div>
        <div class="row">
            <div class="col-sm-6" style="text-align: left">
                到站日期：2017-11-12
            </div>
            <div class="col-sm-6" style="text-align: right">
                提货地址：福建省福州市仓山区望峰路11号2号仓库门
            </div>
        </div>
        <table class="table-striped mtd" style="width: 100%;border: 1px solid darkgrey">
            <tr >
                <td colspan="2">提货网点</td>
                <td colspan="2"></td>
                <td colspan="2">联系电话</td>
                <td colspan="2"></td>
                <td colspan="2">合计票数</td>
                <td colspan="2"></td>
            </tr>
            <tr >
                <td>货号</td>
                <td>收货人</td>
                <td>联系电话</td>
                <td>交货方式</td>
                <td colspan="2">收货地址</td>
                <td colspan="2">货物品名</td>
                <td>件数</td>
                <td>实提件数</td>
                <td>提付</td>
                <td>代收货款</td>
            </tr>
            <tr>
                <td>货号</td>
                <td>收货人</td>
                <td>联系电话</td>
                <td>交货方式</td>
                <td colspan="2">收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址收货地址</td>
                <td colspan="2">货物品名</td>
                <td>件数</td>
                <td>实提件数</td>
                <td>提付</td>
                <td>代收货款</td>
            </tr>
            <tr></tr>
            <tr >
                <td colspan="2">提货人</td>
                <td colspan="2"></td>
                <td colspan="2">身份证号</td>
                <td colspan="2"></td>
                <td colspan="2">联系电话</td>
                <td colspan="2"></td>
            </tr>
            <tr >
                <td colspan="2">提货日期</td>
                <td colspan="2"></td>
                <td colspan="2">备注</td>
                <td colspan="6"></td>
            </tr>
            <tr >
                <td colspan="2">总计费用</td>
                <td colspan="10"></td>
            </tr>
        </table>
        <div class="row">
            <h5>福州鑫合顺物流货物自提清单1</h5>
        </div>
        <div class="row">
            1、
        </div>
        <div class="row">
            2、
        </div>
        <div class="row">
            签字前，务请阅读《提货协议》，签字后表示您理解并接受协议内容。
        </div>
        <div class="row" style="margin-top: 30px;height: 100px">
            <div class="col-sm-3" >
                <h5>提货人签字</h5>
            </div>
            <div class="col-sm-3" style="text-align: start">
                __________________
            </div>
            <div class="col-sm-3">
                <h5>提货日期</h5>
            </div>
            <div class="col-sm-3" style="text-align: start">
                __________________
            </div>
        </div>
        <div class="form-horizontal" id="dotInfoForm">

            <div class="row">

            </div>
            <div class="row btn-group-m-t">
                <div class="col-sm-10">
                    <#button btnCss="info" name="提交" id="ensure" icon="fa-check" clickFun="DotInfoDlg.addSubmit()"/>
                    <#button btnCss="danger" name="取消" id="cancel" icon="fa-eraser" clickFun="DotInfoDlg.close()"/>
                </div>
            </div>
        </div>

    </div>
</div>
<style>
    table{table-layout:fixed;word-wrap:break-word;}

    .mtd td{ height:30px; border:#CCCCCC 1px solid; text-align: center}
</style>
@}
